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Hum Vaccin Immunother. 2017 Oct 3;13(10):2222-2231. doi: 10.1080/21645515.2017.1356496. Epub 2017 Aug 25.

Use of the live attenuated Japanese Encephalitis vaccine SA 14-14-2 in children: A review of safety and tolerability studies.

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a Save the Children , Seattle , WA , USA.
b Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
c Department of Preventive Medicine and Biometrics , Uniformed Services University of the Health Sciences , Bethesda , MD , USA.
d Vaxyn Consulting , Paris , France.


Japanese encephalitis (JE) is the leading cause of viral neurological disease and disability in Asia. Some 50-80% of children with clinical JE die or have long-term neurologic sequelae. Since there is no cure, human vaccination is the only effective long-term control measure, and the World Health Organization recommends that at-risk populations receive a safe and effective vaccine. Four different types of JE vaccines are currently available: inactivated mouse brain-derived vaccines, inactivated Vero cell vaccines, live attenuated SA 14-14-2 vaccines and a live recombinant (chimeric) vaccine. With the rapidly increasing demand for and availability and use of JE vaccines, countries face an important decision in the selection of a JE vaccine. This article provides a comprehensive review of the available safety literature for the live attenuated SA 14-14-2 JE vaccine (LAJEV), the most widely used new generation JE vaccine. With well-established effectiveness data, a single dose of LAJEV protects against clinical JE disease for at least 5 years, providing a long duration of protection compared with inactivated mouse brain-derived vaccines. Since 1988, about 700 million doses of the LAJEV have been distributed globally. Our review found that LAJEV is well tolerated across a wide age range and can safely be given to children as young as 8 months of age. While serious adverse events attributable to LAJEV have been reported, independent experts have not found sufficient evidence for causality based on the available data.


Japanese encephalitis; adverse events; live attenuated SA 14–14–2 vaccine; serious adverse events; vaccine safety

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